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Total and Permanent Disability (or TPD as it is sometimes referred to) is an insurance benefit that is made available under a superannuation fund.

TPD is an insurance benefit available under a superannuation fund. This is available in addition to the contributions (account balance) made by the employer/fund member.

The Superannuation Complaints Tribunal, generally defines TPD as to whether or not a person will ever again be able to work for reward or engage in any gainful employment he/she is reasonably qualified by education, training or experience as a result of an injury or illness.

However, each superannuation fund defines TPD with some differences to the above definition so each fund’s trust deed and/or insurance policy will need to be carefully reviewed to ensure that the criteria of that fund has been met.

We can assist you in submitting the strongest possible claim to the superannuation fund.


Frequent Questions

What is a TPD Benefit?

TPD (commonly known as Total & Permanent Disability or Total & Permanent Disablement) is an insurance benefit available under a superannuation fund. This is available in addition to the contributions (account balance) made by the employer/fund member.

How do I know if I have TPD insurance?

To check if you have TPD insurance, you will have to review your current Superannuation Statement. If you are covered for TPD, it will normally be located near the Death Benefit and will detail the amount for which you’re insured.

Who can claim TPD?

You can make a claim for Total and Permanent Disability if you meet the following requirements:

• You’ve ceased your employment or duties as a result of an illness and/or injury
• You are unlikely to return to work as a result of this illness or injury
• You were under 65 years old when you stopped working
• You were a member of a superannuation fund when you stop working and had a current TPD policy.

What are my rights?

Any rights that you have are governed under your policy document. We will need review the Superannuation Fund Policy Document carefully before we are able to advise you in relation to your rights.

Do I need to resign or be terminated from my employment before making a claim?

You do not need to resign from your employment or be terminated from your employment before a claim can be made. Most Funds require that you be absent from your employment for a continual period of at least 6 months before lodging a claim

My claim was previously rejected, what can I do?

If you have lodged a claim yourself through your fund or insurer and your claim has been rejected, we can help you appeal the decision and force them to undertake a formal review of their file. Even if your claim was initially rejected, there’s a reasonable chance it may be Start proceedings in a court to challenge the decision made by the fund.

How much will it cost?

RaZor Legal operates on a No Win No Fee basis for personal injury claims. Meaning that, for no charge, a qualified expert Lawyer will meet with you, answer your questions and discuss the merits of your claim. When you proceed with the claim, you will only be charged if there is a successful outcome.

What is No Win No Fee?

Quite simply: We will investigate your case, if we advise that you have no claim, there will be no charge. No Win = No Fee. Simple. If you proceed, we will only charge you if your claim is successful.

How long will it take before I receive an outcome?

Every claim is as individual as the person making it. There are many variables with every case that can shorten or prolong the time it takes for a decision to be made, or the claim to be finalised.

The TPD Claim process can be quite lengthy and complex. An investigation with your superannuation fund will need to be undertaken to confirm your TPD cover and obtain the policy document.

A detailed statement will need to be obtained from you in relation to your vocation, work experience/qualifications, injury and illnesses and work history.

Further, all medical evidence by way of a medico-legal report from an independent specialist (this means you will need to attend at an appointment for examination); medical records from your treating practitioners and any other material.

The Claim form together with submissions will then be prepared on your behalf for lodgement with the superannuation fund.

The fund will then make a determination as to whether they accept or reject your claim.

The information provided above is a short run down on the process. It is difficult to determine the length of time for the process as we are dealing with third parties to obtain information.

Contact RaZor Legal to find out more about these claims.

How much do I get?

How much you will get will be dependent upon how much you are insured for, the policy which governs your TPD insurance and whether you decide to take a lump sum amount or a weekly benefit.

Do I pay tax on any benefit that I receive?

Yes, you are required to pay tax on any benefit you receive for TPD as it is considered income. It will need to be declared to the Australian Taxation Office.

We recommend that you seek advice from an accountant or financial planner in relation to this.

Who offers TPD cover?

Most Superannuation Funds offer TPD cover or you can organise your own cover either through a superannuation fund or other insurer.

Does it matter when I start my claim?

There are no time limits as to when to start a TPD claim but it is best to start the process as soon as possible.

There is, however, a six year time period within which to lodge proceedings in the Court. This period starts when a superannuation fund or insurer rejects your claim for the first time.

You only have two years to lodge a complaint with the Superannuation Complaints Tribunal. Please note that complaints are taking a significant amount of time to be heard through the tribunal.

Can I claim more than one TPD claim?

Yes, if you have multiple superannuation funds with multiple insurance policies, a claim can be made against each policy.

I have a personal injury/workers’ compensation/mva/medical negligence claim already – can I start a TPD Claim?

Yes, you can start a TPD Claim. Please be aware that any benefit is received under a TPD Claim is considered income and may affect your personal injury claim. We will be able to provide you with advice in relation to the effects on your other claim.

Further, depending upon your superannuation policy, you may be required to refund (pay back) some or all of any benefit paid from your TPD Claim. We will be able to advise you on this.

CASE STUDIES


STUDY ONE – THE SELF-EMPLOYED MECHANIC

Joe is a 48 yr old self employed mechanic running a successful business.
He does 20% manual work, 30% supervision of other mechanics and 50% administration work.
Joe is married with four children.

Joe is involved in a motor vehicle accident and injures his right arm, back and right leg. Joe had actually fractured his right arm and was unable to move his arm for three months. Joe is right hand dominant.

Thankfully, Joe had an up to date superannuation policy with a TPD Benefit with an “any occupation” definition.

Medically, Joe’s claim is valid as a result of the severe medical trigger and permanent nature of the injury.

The definition of “any occupation” will need to be looked at. Joe can’t participate in the 20% manual work but is still ok to perform the 80% administrative duties, his claim would not meet the definition of “any occupation” TPD.

However if Joe’s workload was 100% manual work and he was untrained or not qualified for any other occupation then he would have a valid TPD Claim.
If you can relate to the above scenario, then we can help you make a claim.

 

STUDY TWO – THE NURSE

Jenny is a Registered Nurse and has been working for Queensland Health for several years. She has also supplemented her income by working weekends with BlueCare.

At 52 years of age, Jenny was diagnosed with breast cancer and although her prognosis was good she decided to take early retirement to focus on her health.

Jenny was automatically covered under a Government Superannuation Scheme for invalidity cover (also known as TPD). Jenny also had a small amount in a HESTA Superannuation Fund being enough to entitle her to income protection insurance.

Under the Government Scheme, Jenny can apply to make a claim for invalidity retirement benefits, The trustee of the scheme will make a decision as to whether or not they accept Jenny’s claim on the basis of medical evidence.

The HESTA income protection insurance will entitle her to benefit payments until she is 60 years old.
If your circumstances are similar to those above, please enquire here as to whether you can make a claim.

 

STUDY THREE – THE TRANSPORT WORKER

Katharine had been employed in the transport industry for approximately 15 years when she was forced to stop working after she was diagnosed with fibromyalgia and chronic fatigue syndrome.

Some 11 years after she ceased working, she became aware that she was able to make a claim for TPD under her superannuation fund.

Katharine’s claim was initially rejected by her superannuation fund but after some perseverance the claim was finally accepted.

Katharine received a lump sum amount to enable her to secure her financial future.
If you have lodged a TPD claim with your superannuation fund and it has been rejected, then call us and we can help you.

 

STUDY FOUR – THE SALES REPRESENTATIVE AND FAMILY MAN

Deon, a 23 year old man, worked for a national retailer as a sales representative.
He is married with two young children and many household expenses.

Deon’s doctor diagnosed him as having MS when he began feeling extremely tired. He resigned from his position at the retailer. Deon was never made aware that he could make a TPD claim under his superannuation policy.

It was by accident, that he heard somebody talking about superannuation and the insurance attached to it and decided to look into whether or not he could make a claim.

Thankfully, Deon had TPD cover attached to his superannuation and was able to make a claim. The trustee for the Superannuation fund accepted his claim and made a lump sum payment that has made life easier for him and his family.

Please call us if you are in similar circumstances to those stated above.

If you are unable to work as a result of injury or illness, there may be other avenues available to you including income protection claims, life insurance claims, disability claims and early release of superannuation benefit claims. Please contact RaZor Legal to discuss the avenues available to your situation.

 

GLOSSARY (commonly used words)

‘Injury/Illness’ means (including but not limited to) cancer, mental illness, multiple sclerosis, chronic fatigue syndrome, heart attack, stroke, chronic lung disease, major head trauma, motor neurone disease, spinal injury, brain injury or disease and injuries from a motor vehicle accident or workplace etc;

‘any occupation’ means any occupation based on your skills and knowledge you have acquired through previous education, training and work experience.

‘own occupation’ means your general area of expertise, for example a manager or a professional.

‘fund or insurer’ means superannuation fund

“Unlikely to ever work again” – the ordinary meaning of the word “unlikely” is applied but the word “ever” allows a trustee to look well into the future. In determining whether a member is “unlikely” to ever be able to work again in a job for which that person is so qualified, the realities of the labour market must also be considered;

“Full time/ Part time work” – the test will be if a member was working full time or part time at the date of injury or illness then the test is whether the member is likely to be able to engage in either full time or part time work – whatever the case may be;

“Reasonably qualified” or “Reasonably suited” – this means considering whether a person is unable to engage in any employment that is suited to them in terms of education, training or experience. In this instance, issues of retraining, transferable skills and likelihood of obtaining employment is relevant.

“As a result of” – the member’s cessation of employment must be as a result of the member’s TPD.

‘Benefit’ means the insurance benefit payable over and above the compulsory superannuation payments.


USEFUL LINKS

SUPERANNUATION COMPLAINTS TRIBUNAL (SCT)
complaints after you have tried to sort an issue out with your superannuation fund.
www.sct.gov.au

FINANCIAL OMBUDSMAN SERVICE (FOS)
A complaint may be issued with FOS to sort out an issue with your superannuation fund.
www.fos.org.au

AUSTRALIAN SECURITIES AND INVESTMENT COMMISSION (ASIC)
FIDO can assist you with useful calculators and tools including a search function to find lost super and other money.
www.fido.gov.au

ASSOCIATION OF SUPERANNUATION FUNDS OF AUSTRALIA (ASFA)
Fact sheets, calculators and other useful tools.
www.asfa.asn.au

AUSTRALIAN PRUDENTIAL REGULATION AUTHORITY (APRA)
The body that regulates mismanaged super funds.
www.apra.gov.au

AUSTRALIAN TAXATION OFFICE (ATO)
www.ato.gov.au

CENTRELINK FINANCIAL INFORMATION SERVICE
Financial information and seminars.
www.centrelink.gov.au